Academic Medicine最新文献

{"title":"Take Charge of Your Professional Network of Colleagues to Succeed in Academic Medicine.","authors":"Kathleen Huth, Lori Newman, Lisa Meeks, Traci Wolbrink","doi":"10.1097/ACM.0000000000005970","DOIUrl":"10.1097/ACM.0000000000005970","url":null,"abstract":"<p><p>In 2021, nearly 6% of learners studying medicine disclosed disabilities, which was more than double that of 2015.1 Learners seek accommodations for visual, hearing, mobility, and learning disabilities, as well as chronic health conditions. Strategies for supporting accessibility align with best practices for audiovisual and instructional design; however, they are not consistently used in online education. Health professions educators are responsible for ensuring online content is accessible to all learners.</p>","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":"874"},"PeriodicalIF":5.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coaching, Too, Should Count Toward Academic Promotion and Career Advancement.","authors":"Denise H Wong, Justin K Lui","doi":"10.1097/ACM.0000000000006023","DOIUrl":"10.1097/ACM.0000000000006023","url":null,"abstract":"","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":"762"},"PeriodicalIF":5.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143607019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation of a Policy for Accommodations for Physicians With Disabilities.","authors":"Camille Munro, Greg Knoll, Kathleen Gartke, Krista Hind, Michael Quon","doi":"10.1097/ACM.0000000000006027","DOIUrl":"10.1097/ACM.0000000000006027","url":null,"abstract":"<p><strong>Abstract: </strong>Although physicians with disabilities are underrepresented in medicine, their lived experiences of disability can increase empathy for patients, enrich the learning environment, and improve working conditions. However, they face barriers related to procedures, policies, clinical accommodations, disability and wellness support services, and physical environments as well as cultural barriers that affect their meaningful inclusion and ability to work at their full capacity. Despite national Canadian physician organizations recommending accommodations and inclusive policies and practices, an environmental scan of the top 10 ranked Canadian hospital institutions in April-May 2020 did not identify any existing accommodations policies.The Medical Advisory Committee and senior management team at The Ottawa Hospital (TOH) formally endorsed the first position statement in Canada supporting physicians with disabilities in 2021, which led to the establishment of a process to develop and implement an accessibility and accommodations policy for the Department of Medicine (DOM) at TOH. After careful review and an iterative development process, the DOM approved a formal Accessibility and Accommodations Policy in June 2022. The policy ensures physicians are accommodated during the recruitment, interview, and appointment phases. It outlines a process for the development of an accommodation plan, addresses funding for accommodations, protects physicians returning to work following absences due to a disability, and requires exploration of opportunities for physicians to make a meaningful contribution if they cannot practice clinically due to their disability.In this article, the authors discuss the process of developing and implementing the DOM Accessibility and Accommodations Policy, outline the key elements of the policy, and discuss broader implementation of the policy and how they are monitoring its impact. They also discuss the importance and benefits of collecting data on physicians who self-identify as having a disability and, through confidential surveys, focus groups, and interviews, monitoring the impact of accessibility and accommodations policies.</p>","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":"781-785"},"PeriodicalIF":5.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Story We Are Not Telling.","authors":"Nneka Ede","doi":"10.1097/ACM.0000000000006008","DOIUrl":"10.1097/ACM.0000000000006008","url":null,"abstract":"","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":"786"},"PeriodicalIF":5.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143460488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Delusions of Reference.","authors":"Lisa Gong","doi":"10.1097/ACM.0000000000006015","DOIUrl":"10.1097/ACM.0000000000006015","url":null,"abstract":"","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":"859"},"PeriodicalIF":5.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How Shame Shaped Me: Exploring the Impact of Shame on Professional Identity Formation in Medical Trainees.","authors":"Gayle Haischer-Rollo, Holly Meyer, K Christopher McMains, Lara Varpio, William E Bynum","doi":"10.1097/ACM.0000000000006048","DOIUrl":"10.1097/ACM.0000000000006048","url":null,"abstract":"<p><strong>Purpose: </strong>In medical education, the influence of shame is largely absent from current conceptualizations of professional identity formation (PIF), even though this process is susceptible to the effects of shame experiences. This study endeavors to examine how shame influences PIF among medical learners.</p><p><strong>Method: </strong>Adopting a constructivist approach and hermeneutic phenomenology, the authors interviewed 9 final-year graduate medical trainees at 2 U.S. military medical centers between September 2022 and February 2023. The authors used a semistructured interview guide and photo-elicitation to deeply explore participants' shame experiences and how these influenced participants' PIF. Data analysis focused on understanding the lived experiences of these events and their impact on PIF, yielding themes central to the phenomenon of shame-induced PIF that helped characterize its deeper meaning.</p><p><strong>Results: </strong>Participants described shame events triggered by incidents like board exam failure, patient care mistakes, and needing educational remediation. Analyzing the influence of these events on PIF revealed 2 processes that helped propel identity arcs toward-and sometimes away from-an ideal version of the self: identity disruption and identity work. Identity disruption led to a distancing from the community and could lead to isolation, anxiety, and impaired belonging. These feelings of disruption often led to significant identity work, which involved modifying self-talk, leveraging agency, and engaging in identity negotiation (often in service of growth toward a modified professional identity).</p><p><strong>Conclusions: </strong>This study uncovers the potential for shame to serve as a catalyst for meaningful identity work in medical trainees. The findings expand on existing conceptualizations of PIF by highlighting that it is a dynamic, ongoing, nonlinear, and multidimensional process. The analysis points to actions educators and learners can take to support learners' constructive navigation of shame experiences and their impact on PIF.</p>","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":"801-809"},"PeriodicalIF":5.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Practical Skills Teaching by Near-Peers and Faculty.","authors":"Roman Hari, Sarah Oppliger, Diana H J M Dolmans, Sören Huwendiek, Renée E Stalmeijer","doi":"10.1097/ACM.0000000000006003","DOIUrl":"10.1097/ACM.0000000000006003","url":null,"abstract":"<p><strong>Purpose: </strong>Near-peer teaching is a vital teaching resource in most medical schools, but little is known about the comparative benefits of near-peers and faculty teaching or the learning mechanisms that underlie them. This study explored near-peers' and students' perceptions of differences between the way near-peers and faculty teach practical skills.</p><p><strong>Method: </strong>Using qualitative methods, the authors conducted 4 focus groups with near-peers (n = 22) and 4 focus groups with students (n = 26, years 3-6) at the University of Bern, Bern, Switzerland, between September and December 2022. All participants recently participated in near-peer skills training. Vignettes of typical teaching situations guided the focus group discussions. The reflexive thematic analysis was both inductive and deductive; cognitive apprenticeship teaching methods informed the deductive analysis.</p><p><strong>Results: </strong>Three major areas of difference were identified in near-peers and faculty skills teaching methods: (1) learning climate, (2) teaching orientation, and (3) reaction to identified competence gaps and students' questions. Near-peers were perceived to establish a safer learning climate than faculty, lowering the threshold to ask questions. Near-peer teaching was oriented toward the formal curriculum and students' learning needs, resulting in more tailored explanations focused on examination-relevant content. Faculty oriented their teaching toward clinical practice, which helped students transition to clinical practice but could overwhelm novice students. Faculty better stimulated students to think critically about unanswered questions and how to fill their competence gaps.</p><p><strong>Conclusions: </strong>Skills teaching by near-peers and faculty differed in teaching climate and orientation. Near-peers saw students as learners, focused on the learning climate and on students' needs. Faculty saw students as future physicians and facilitated the transition from curricular learning to clinical practice. Curricular design should capitalize on the complementary benefits of near-peer and faculty skills instructors and seek to get the best of both worlds.</p>","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":"820-827"},"PeriodicalIF":5.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12237129/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143575974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Variability in Learner Performance Using the ACGME Harmonized Milestones During the First Year of Postgraduate Training.","authors":"Sally A Santen, Michael S Ryan, Tonya L Fancher, Tyler Carcamo, Sean O Hogan, Laurah Turner, Jeffrey J H Cheung, Katherine Berg, Moshe Feldman, Eric S Holmboe, Yoon Soo Park","doi":"10.1097/ACM.0000000000006053","DOIUrl":"10.1097/ACM.0000000000006053","url":null,"abstract":"<p><strong>Purpose: </strong>Postgraduate medical training in the United States requires formative assessments of learners using the Accreditation Council for Graduate Medical Education (ACGME) milestones system. With Milestones 2.0, Harmonized Milestones (HMs) for 4 competency domains (professionalism, communication and interpersonal skills, systems-based practice, and practice-based learning and improvement) across specialties were developed. Performance of postgraduate trainees across specialties and at the transition to residency can be explored with the HMs. This study examined the factors that contribute to the variability in the assessments of postgraduate year 1 (PGY-1) learners as measured using Milestones 2.0.</p><p><strong>Method: </strong>This retrospective study assessed national ACGME HM data from PGY-1 residents at U.S. medical schools in July 2021 and 2022 from the 6 largest specialties: emergency medicine, family medicine, internal medicine, general surgery, psychiatry, and pediatrics. Variance component analyses were conducted using cross-classified random-effects models, accounting for clustering; estimated variance components were used to generate inference on contribution of learner variability due to residency program, medical school, and specialty and make inferences on HM rating practices, including straight-lining.</p><p><strong>Results: </strong>The sample included 57,132 PGY-1 residents (2,430 programs). Specialty accounted for the largest variance (22%) across HM competency domains. Within specialty, variance components for trainees, residency programs, and medical schools accounted for 22%, 35%, and 2% of total variance, respectively. Straight-lining was found at 6 months for 6,827 of 56,804 PGY-1 residents (12%), with the greatest amount in surgery (2,105 of 5,559 [38%]).</p><p><strong>Conclusions: </strong>This study found variability in HM performance across 6 specialties due to medical schools, specialty, residency programs, and trainees with limited variability attributed to medical school and learner. Substantial differences across specialties call for the need for clinical educators, researchers, and accreditors to create a shared mental model to bolster the evaluative strength of milestones and prepare residents for the needs of health care.</p>","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":"852-859"},"PeriodicalIF":5.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12237136/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Establishing a Working Group on \"Spirituality and Health\" at the Brazilian Association of Medical Education.","authors":"Giancarlo Lucchetti, Paulo Othavio de Araujo Almeida, Elena Zuliani Martin, Ana Claudia Chazan","doi":"10.1097/ACM.0000000000006026","DOIUrl":"10.1097/ACM.0000000000006026","url":null,"abstract":"","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":"762-763"},"PeriodicalIF":5.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143607052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancing Women Physicians in Academic Medicine: A Scoping Review.","authors":"Neha J Purkey, Peggy Han, Amanda Woodward, Alexis S Davis, Lindsay Johnston, Robin Klein, Catherine D Krawczeski, Kristen T Leeman, Kerri Z Machut, Meghna D Patel, Melissa Scala, Mary E McBride","doi":"10.1097/ACM.0000000000006052","DOIUrl":"10.1097/ACM.0000000000006052","url":null,"abstract":"<p><strong>Purpose: </strong>Multiple studies have described higher rates of attrition for women in academic medicine, but actionable strategies to retain women in the field have not been well studied in the current era. This study reviewed the existing literature for studied interventions to support the advancement of women physicians in academic medicine.</p><p><strong>Method: </strong>A scoping review was conducted by searching the PubMed, Embase, and Scopus databases for articles describing interventions intended to support women physicians on September 12, 2022, and updated on August 23, 2024. All articles from inception of the databases through the search dates were included. Search terms included female physician , mentoring , leadership , career development , job satisfaction , advancement , and synonyms. Articles related to inequities in patient care, interventions related to nonphysician health care workers, and studies describing sexism without measured solutions were excluded from the analysis. Kirkpatrick's framework for the evaluation of educational programs was used to further classify results by 4 levels of evaluation for an educational or training program: reaction, learning, behavior, and results.</p><p><strong>Results: </strong>A total of 2,813 articles underwent abstract screening and full-text review, with 64 articles included in the final analysis. Seven studies (10.9%) were randomized controlled trials. Only 2 studies (3.1%) specifically examined mid- or late-career women. Career development programs (15 [23.4%]), mentorship programs (10 [15.6%]), and women's interest groups (7 [10.9%]) were the most described interventions. Outcome measures were most commonly satisfaction with the intervention (22 [34.4%]), self-perceived improvement in skills (17 [26.6%]), and representation or recruitment of women into a field (12 [18.8%]).</p><p><strong>Conclusions: </strong>This study describes 64 articles of studied interventions to support the advancement of women in medicine. Additional studies are needed and should emphasize rigorous study methods, a focus on institutional solutions, and identifying and targeting the needs of women physicians beyond their early career.</p>","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":"860-870"},"PeriodicalIF":5.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}